Bipolar Affective Disorder

Bipolar affective disorder is a disease in which the mood and activity of those affected are changed significantly. There will be a change of episodes with elevated mood, increased energy levels and activity (so-called “hypomanic” or “manic” episodes) and episodes of depressed mood and reduction of energy and activity.

According to the severity of the manic or hypomanic symptoms the bipolar affective disorders can be divided into the bipolar I disorder (with depressed and manic episodes) and bipolar II disorder (with depressed and hypomanic episodes).

In mania, the mood of those affected is extremely lifted and can range from careless gaiety to almost uncontrollable excitement. The elation is associated with an increased energy levels, this leads to hyperactivity, pressured speech and decreased need for sleep. Patients find it difficult to keep up their attention and are easily distracted.

The self-assessment is over-optimistic. Loss of normal social inhibitions may lead to inappropriate behavior or result in a careless, reckless behavior or. In addition the mania may lead to the occurrence of psychotic symptoms with delusions (mostly delusions of grandeur) or hallucinations (usually voices speaking directly to those affected).

The excitement, the high physical activity and flight of ideas can be so extreme that those affected are inaccessible to a normal conversation.

The term hypomania is defined as a disease characterized by a persistently slightly elevated mood, increased energy levels and increased activity, and is usually characterized by a striking sense of well-being and physical and mental performance.

Common among those affected is also a increased sociability, talkativeness, over-familiarity, increased libido and a decreased need for sleep. This, however, not in a degree that would lead to a termination of employment or social rejection. Instead of the euphoric sociability can also occur irritability, overconfidence, and (particularly in adolescents) boorish behavior.

National Institute for Health an Clinical Excellence - NICE (2014). Bipolar disorder: The NICE guideline on the assessment and management of bipolar disorder in adults, children an young people in primary and secondary care. National Clinical Practice Guideline 185. London: British Psychological Society, The Royal College of Psychiatrists.Full text (pdf) >>

Royal Australian and New Zealand College of Psychiatrists RANZCP - Clinical Practice Guidelines Team for Bipolar Disorder (2004). Australian and New Zealand clinical practice guidelines for the treatment of bipolar disorder. Australian and New Zealand Journal of Psychiatry 38:280–305.Abstract >>